Flawed research and its enduring repercussions

doi:10.1126/science.abb3587

GSTDTAP > 气候变化

DOI	10.1126/science.abb3587
	Flawed research and its enduring repercussions
	Paul A. Offit
	2020-10-02
发表期刊	Science
出版年	2020
英文摘要	On 26 February 1998, the Royal Free Hospital in London held a press conference to announce that a study conducted by one of the hospital's clinicians would be published in The Lancet , one of the world's oldest and most prestigious medical journals. Sitting at the front of the room was the senior author, Andrew Wakefield, who explained that the combination measles-mumps-rubella (MMR) vaccine could cause developmental delays, including autism. Wakefield argued that the MMR vaccine suppressed the immune system in some children, freeing the measles vaccine virus to damage the intestine, which allowed encephalopathic proteins to enter the circulation, cross the blood-brain barrier, and destroy brain cells. He called for MMR vaccinations to cease until more research could be conducted. Wakefield became an international hero. A biopic starring British actor Hugh Bonneville portrayed him as a courageous man willing to speak truth to power. In the United States, Wakefield testified before the Congressional Committee on Government Reform and appeared on 60 Minutes with Ed Bradley. Then along came Brian Deer, an investigative reporter working for The Sunday Times . Deer would become the first to expose the clinician's undisclosed financial associations and unearth troubling problems with the Lancet paper. In The Doctor Who Fooled the World , Deer recounts in vivid detail how he came to learn that Wakefield and his study were not what they appeared to be. Deer reveals that children admitted to the Royal Free Hospital with developmental delays in the 1990s were subjected to a regime known as the Wakefield protocol, which entailed magnetic resonance imaging, electroencephalography, spinal taps, abdominal x-rays, blood tests, and intestinal biopsies—procedures often not indicated by the children's symptoms. “The Royal Free would become the Mecca, or Lourdes,” he writes, “for the desperately questing families of developmentally challenged children.” Wakefield, we learn, had received £435,643 (the equivalent of $846,000 today) to conduct studies that would help build a legal case against MMR vaccine producers 2 years prior to the Lancet publication. And although he reported that the children in his study were referred to his hospital through routine channels, many came from an antivaccine group called JABS and the lawyer preparing to sue vaccine makers. In June 1997, further undermining the sentiment the physician would convey at the 1998 press conference (“It's a moral issue for me”), Wakefield submitted a patent for a product that claimed to treat so-called “autistic enterocolitis,” rid the body of harmful toxins, and immunize safely against measles. Deer reveals that Wakefield also misrepresented clinical, biological, and molecular data. Although the 12 children in his paper were described as having suffered developmental problems within 2 weeks of vaccination, for example, Deer discovered that some had begun displaying symptoms before receiving the MMR vaccine whereas others did not begin exhibiting symptoms until months afterward. Moreover, there were instances in which normal intestinal biopsy specimens were mischaracterized as colitis, and Wakefield's claim that the measles vaccine virus genome was present in intestinal epithelial cells of children with autistic enterocolitis was inconsistent and irreproducible. As a consequence of these and other revelations, The Lancet retracted the paper, and Wakefield lost his license to practice medicine. Subsequent studies have shown that children who receive the MMR vaccine are at no greater risk of developmental delays than those who do not receive it. Nonetheless, the damage was done. The Wakefield study helped to accelerate the antivaccination movement that has imperiled children and led to the resurgence of once-controlled diseases. Although many people think they know this now-infamous story, it is likely they are unaware of all its dramatic details. Curious lay readers and vaccine experts alike are sure to learn something worthwhile from Deer's well-chronicled account.
领域	气候变化 ; 资源环境
URL	查看原文
引用统计
文献类型	期刊论文
条目标识符	http://119.78.100.173/C666/handle/2XK7JSWQ/298042
专题	气候变化资源环境科学
推荐引用方式 GB/T 7714	Paul A. Offit. Flawed research and its enduring repercussions[J]. Science,2020.
APA	Paul A. Offit.(2020).Flawed research and its enduring repercussions.Science.
MLA	Paul A. Offit."Flawed research and its enduring repercussions".Science (2020).